Depression and dementia in the elderly

Cathy S. Babao
-
2 years ago

Over the last couple of weeks, in conversation with close friends and contemporaries, two “D” words kept surfacing: depression and dementia.

Perhaps it’s because we’re now in the life stage where we’re almost done caring for our children, and find ourselves parenting our parents. There are many emotions that come with the realization that mom or dad is no longer the parent we once knew. It becomes even more important to nurture oneself at this life stage because, suddenly, the roles have been reversed.

Depression in the senior population is a reality but may sometimes remain undiagnosed, because sadness in the elderly is not often the main symptom. There may be other, less obvious symptoms of depression such as anger, irritability or forgetfulness.

According to the US National Institute on Mental Health (NIMH), depression has many symptoms, including physical signs. Watch out if your elderly loved one has been experiencing any or several of the following symptoms for at least two weeks:

Persistent sad, anxious or

“empty” mood

Loss of interest or pleasure in

hobbies and activities

Feelings of hopelessness,

pessimism

Feelings of guilt, worthless-

ness, helplessness

Decreased energy, fatigue,

being “slowed down”

Difficulty concentrating, re-membering, making decisions

Difficulty sleeping, early-

morning awakening, or over-

sleeping

Appetite and/or unintended

weight changes

Thoughts of death or suicide,

suicide attempts

Restlessness, irritability

Aches or pains, headaches,

cramps, or digestive prob-

lems without a clear physical

cause and/or that do not ease

even with treatment

Higher risk

Depression is very real for the senior population, but certain people are at higher risk. If you are an older adult, you may be at a higher risk if you are female, have a chronic medical illness such as cancer, diabetes or heart disease, have a disability, sleep poorly, are lonely or socially isolated.

The risk increases if there is a personal or family history of depression, if you use certain medications, have experienced stressful life events such as loss of a spouse, or if you are taking care of someone with a chronic illness.

If you have an elderly friend or family member whom you suspect is depressed, please go and see a professional such as a psychiatrist or a geriatrician— doctors whose field of specialization are illnesses among the senior population.

Some of the things you can do to help the elderly grappling with depression are: offering support, understanding, patience and encouragement. Talk to them regularly, and listen carefully. Talk of suicide must never be ignored. Take them out of the house for a walk, or if housebound, engage in fun indoor activities.

The World Health Organization (WHO) anticipates a huge spike in the number of patients with dementia. “Dementia: A Public Health Priority,” published by the WHO and Alzheimer’s International in 2012, states: “The number of people living with dementia worldwide is currently estimated at 35.6 million. This will double by 2030 and more than triple by 2050.”

Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.

Alzheimer’s disease accounts for 60 to 80 percent of cases, while vascular dementia, which occurs after a stroke, is the second most common dementia type.

However, there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies.

Core mental functions

Dementia is often incorrectly referred to as “senility” or “senile dementia,” or, in Tagalog, “nag-uulianin,” which is incorrect because serious mental decline is not a normal part of aging.

According to the Alzheimer’s Association (www.alz.org), symptoms of dementia can vary greatly, but at least two of the following core mental functions must be significantly impaired to be considered dementia:

Memory

Communication and language

Ability to focus and pay

attention

Reasoning and judgment

Visual perception

If you suspect that your loved one might be suffering from dementia, it is important to get an early diagnosis so that treatment to delay the progression of memory loss can start.

In the Philippines, a battery of cognitive and psychological testing and interviews may be requested by the primary doctor and, if necessary, a brain scan to determine the nature of the problem.

But it’s harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap.

Patients with dementia need to have adequate socialization. Some organizations, such as the Grandparent’s Club at St. Luke’s Medical Center, have programs for the elderly where they do crafts.

Some local government units provide programs within the community to help entertain and keep seniors occupied.

Dancing has been proven to delay the progression of dementia. The key is to stay active mentally, socially and, as much as possible, physically—even if one is in the sunset years—to keep not just depression, but dementia at bay.